Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina.
Center for Research in Epidemiology and Public Health, National Scientific and Technical Research Council, Buenos Aires, Argentina.
Oncologist. 2021 May;26(5):e794-e806. doi: 10.1002/onco.13709. Epub 2021 Feb 25.
Breast cancer (BC) is the most common cancer in women. It imposes a huge disease burden and a significant impact on health-related quality of life (HRQoL). Our study focused on HRQoL of patients with BC in Latin America and the Caribbean (LAC). We conducted a systematic review to identify relevant articles published between 2008 and August 2018. We conducted several meta-analyses and subgroup analyses by country, disease stage, and instrument used (Prospective Register Of Systematic Reviews registration number: CRD42018106835).
From 2,265 initial references, we finally included 75 articles (8,806 participants) that assessed HRQoL. The European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire C30 and B23 modules (34 studies; 8 countries; 4,866 participants) were the most used instruments, followed by the Short Form 36-item, the abbreviated version of the World Health Organization Quality of Life instrument, and the Functional Assessment of Cancer Therapy - Breast instrument. Only four studies reported specific HRQoL data of patients with metastatic disease. Half the studies were rated as having moderate quality (38/75), and 38% (29/75) as high quality. We identified substantial heterogeneity. As expected, the meta-analyses revealed that patients with metastatic disease reported lower HRQoL values and high symptom burden compared with patients at earlier stages. Similar results can be observed when we compared patients with early breast cancer in active treatment phases versus those in follow-up.
This study provides a synthesis of breast cancer HRQoL reported in LAC and exposes existing evidence gaps. Patients with BC in active treatment or with metastatic disease had worse HRQoL compared with survivors during the follow-up period.
This systematic review provides an exhaustive synthesis of breast cancer health-related quality of life in women in the Latin American and Caribbean region. Patients with breast cancer in active treatment or with metastatic disease had worse health-related quality of life compared with survivors during the different follow-up periods. This study also shows important evidence and methods gaps that can help inform future research.
乳腺癌（BC）是女性最常见的癌症。它给患者带来了巨大的疾病负担和严重的健康相关生活质量（HRQoL）影响。我们的研究重点是拉丁美洲和加勒比地区（LAC）的乳腺癌患者的 HRQoL。我们进行了系统评价，以确定 2008 年至 2018 年 8 月期间发表的相关文章。我们根据国家、疾病阶段和使用的仪器进行了几项荟萃分析和亚组分析（前瞻性注册系统评价注册编号：CRD42018106835）。
从 2265 篇初始参考文献中，我们最终纳入了 75 篇文章（8806 名参与者），评估了 HRQoL。欧洲癌症研究与治疗组织的生活质量问卷 C30 和 B23 模块（34 项研究；8 个国家；4866 名参与者）是最常用的工具，其次是简短的 36 项生活质量问卷、世界卫生组织生活质量问卷简短版和功能性癌症治疗评估 - 乳房工具。只有四项研究报告了转移性疾病患者的特定 HRQoL 数据。一半的研究被评为中等质量（38/75），38%（29/75）为高质量。我们发现存在很大的异质性。正如预期的那样，荟萃分析表明，与早期阶段的患者相比，转移性疾病患者报告的 HRQoL 值更低，症状负担更高。当我们将处于积极治疗阶段的早期乳腺癌患者与处于随访阶段的患者进行比较时，也可以观察到类似的结果。
本研究总结了拉丁美洲和加勒比地区报告的乳腺癌 HRQoL，并揭示了现有证据差距。与随访期间的幸存者相比，处于积极治疗或转移性疾病的乳腺癌患者的 HRQoL 更差。
本系统评价全面总结了拉丁美洲和加勒比地区女性乳腺癌健康相关生活质量。与不同随访期间的幸存者相比，处于积极治疗或转移性疾病的乳腺癌患者的健康相关生活质量更差。这项研究还显示了重要的证据和方法差距，这可以帮助指导未来的研究。
